This randomized prospective study evaluated the surgical pass tray to reduce intraoperative glove perforation during cesarean delivery. Surgical team members were assigned to employ normal instrument pass techniques or surgical pass tray during all cesarean deliveries. Surgical team members were asked to record their surgical role and level of training. Gloves were collected and tested using standard hydrosufflation techniques. Additional variables studied were patient weight, surgical indication, estimated blood loss, and length of surgery. A total of 192 cesarean sections were performed during the study period, for which 165 were studied. Data collection was considered adequate in 156 cases. Four hundred forty-four pairs of gloves were collected and tested, including 38 double glove sets. Seventy-eight perforations were noted in 444 pairs of gloves, including 11 in the double glove sets. Among surgeries assigned to use pass trays, 221 pairs of gloves were obtained with 42 (19.0%) perforations noted. Surgeries assigned to the control group contributed 223 glove sets of which 36 (16.1%) perforations were noted (P = .5). There were no complete perforations noted in the total of double glove sets. The frequency of glove perforations is not reduced by using surgical pass trays. While there is no demonstrated benefit in using pass trays there appears to be little adverse impact.